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JAMA Ophthalmology Clinical Challenge
December 19, 2019

Atypical Conjunctival Lesion Associated With a Bladder Problem

Author Affiliations
  • 1Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
  • 2Ocular Pathology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA Ophthalmol. Published online December 19, 2019. doi:10.1001/jamaophthalmol.2019.4596

A white man in his 70s was referred for evaluation of a rapidly enlarging fleshy nodule of the right nasal conjunctiva. The patient noted redness, pain, and a foreign body sensation on his right eye for 2 weeks. The general ophthalmologist prescribed a 3-week course of oral prednisone, 20 mg/d, that reduced surrounding inflammation and pain, but the lesion did not change in appearance. The chest radiographic findings and blood work results were unremarkable. The lack of response to oral prednisone therapy led to suspicion of a possible malignant neoplasm, and the patient was referred for our opinion.

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